A blog covering the health/care ecosystem and people.

When the head of the Consumer Electronics Association gives a shout-out to the growth of health products in his annual mega-show, attention must be paid. The #2014CES featured over 300 companies devoted to “digital health” as the CEA defines the term. But if you believe that health is where we live, work, play, and pray, then you can see health is almost everywhere at the CES, from connected home tech and smart refrigerators to autos that sense ‘sick’ air and headphones that amplify phone messages for people with hearing aids, along with pet activity tracking devices like the Petbit. If

In the battle of wearable devices for digital health at this year’s Consumer Electronics Show, it’s sleep that’s the #1 new extension on activity tracking. Sleep, or lack thereof, is a prevalent challenge for people who increasingly live electronic lifestyles on-the-grid. And, lack of sleep is a major health risk for obesity, heart conditions, and mental acuity. A new Swedish study published in the peer-reviewed journal Sleep has found that sleep protects brain health. With the demise of the dedicated sleep device Zeo in 2013, popular sleep trackers with market shares have the opportunity to add sleep functions to their tools.

The rise of digital health at the 2014 Consumer Electronics Show signals the hockey-stick growth of consumer-facing health devices for fitness and, increasingly, more medical applications in the hands of people, patients, and caregivers. This year at #CES2014, while the 40% growth of the CES digital health footprint will get the headlines, the underlying story will go beyond wristbands and step-tracking generating data from an N of 1 to tools that generate data to bolster shared-decision making between people and the health system, and eventually support population health. For example: – Aetna is partnering with J&J to deploy their Care4Today

Gird your wallets, U.S. consumers: watch the dollars flow out-of-pocket for prescription drugs in 2014, as predicted by the 2013-2014 Prescription Drug Benefit Cost and Plan Design Report published by the Pharmacy Benefit Management Institute (PBMI) this week. Constraints covering most plan members are: Step therapy Prior authorization (to get approvals to fill high-cost drugs, notably growth hormones, injectables, controlled substances, Retin-A, and medications for sleep disorders, and Compulsory 90 day refills at retail (90-day dispensing for chronic meds). This Report, sponsored by Takeda, is the gold standard of drug benefit trends, having been published since 1995. Average 30-day copayments

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

Games are part of peoples’ lives in the 20-teens. Gamification has been used in military and business training and now is a growing method to help change peoples’ behavior across a variety of issues — health, among them. But it’s not all “fun and games” when it comes to succeeding in applying gaming methods in health, according to Gaming to Engage the Healthcare Consumer, a report from ICF International. ICF’s roots are in the defense industry, and the team that wrote this paper together have decades of experience in military applications. These learnings can be quite useful when translated into the

  Money and health are two things most people don’t like to talk about. But if people and their doctors spoke more about health and finance, outcomes (both fiscal and physical) could improve. In late October 2013, Best Practices for Communicating with Patients on Financial Matters were published by the Healthcare Financial Management Association (HFMA). Michael Leavitt, former head of the Department of Health and Human Services, led the year-long development effort on behalf of HFMA, with input from patient advocates, the American Hospital Association, America’s Health Insurance Plans, the American Academy of Family Physicians and the National Patient Advocate Foundation, along

Patient and health engagement is the flavor du jour in health circles these days, from the corridors of hospitals to the caffeinated marketing meetings in Big Pharma’s east coast meet-ups. But there’s no standard agreement on what we mean by peoples’ health engagement, whether by patient or well consumer. In Market Insights: The Evolution of Consumer Engagement in Health Care, Porter Research endeavors to deepen our understanding of this important concept. In the introductory section of the paper, “Understanding Engagement,” Porter proffers that industry – providers, payers and employers – consider engagement as “changing consumer behavior through increased participation in consumers’ own health

Consumers embrace ongoing dialog with the companies they do business with, Varolii Corporation toplines in a survey report, What Do Customers Want? A Growing Appetite for Customer Communications. Across all vertical industries consumers trust for this dialogue, health care organizations – specifically doctors, pharmacists, and insurance companies – are the most trusted. Examples of “welcome-comms” would be reminders about upcoming appointments or vaccinations (among 69% of people), notices to reorder or pick up a prescription (57%), and messages encouraging scheduling an appointment (39%). In banking, notices about fraudulent activity on one’s account is the most welcomed message beating out appointment

The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention

Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth

Since the advent of the so-called consumer-directed health care era in the mid-2000s, there’s been a love-gap between health plan members of traditional plans, living in Health Plan World 1.0, and people enrolled in newer consumer-driven plans – high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs). That gap in plan satisfaction continues, according to the Employee Benefits Research Institute (EBRI)’s poll of Americans’ consumer engagement in health care. The survey was conducted with the Commonwealth Fund. As the bar chart illustrates, some 62% of members in traditional plans were satisfied (very or extremely) with their health insurance in 2012.

Imagine walking into a storefront where you can shop for an arthroscopy procedure, mammogram, or appointment with a primary care doctor based on price, availability, quality, and other consumers’ opinions? Welcome to the “health care automat,” the online healthcare marketplace. This is a separate concept from the new Health Insurance Marketplace, or Exchange. This emerging way to shop for and access health care services is explored in my latest paper for the California HealthCare Foundation (CHCF), Help Yourself: The Rise of Online Healthcare Marketplaces. What’s driving this new wrinkle in retail health care are: U.S. health citizens morphing into consumers,

Consumers in America are spending more, and especially at the grocery store. Most people say they want to eat healthy — but, although they’re spending more at the food store, one-half of supermarket shoppers say cost is the main obstacle for healthy eating. 2 in 3 U.S. grocery shoppers define health and wellness as being physically fit and active, and over half believe that feeling good about yourself is another facet of health. Not being overweight equals health for about one-half of U.S. shoppers. The Why? Behind the Buy, from Acosta Sales & Marketing, explores buying patterns among U.S. consumers

Health consumers, meet a new player in your health care world: the bank. Financial services companies will play a growing role in U.S. health care as patients morph into health care consumers responsible for making more money-based decisions about their health care. This shift could make paying for health care just like paying other bills in the consumer retail market. And that’s a new role for health providers – doctors and hospitals – to fill. The Impact of Growing Patient Financial Responsibility on Healthcare Providers, prepared for Citi Enterprise Payments by Boundary Information Group, discusses what the impact of consumers’ payments in

While there is big uncertainty about how health reform will roll out in 2014, and who will opt into the new (and improved?) system, health cost growth will slow to 6.5% signalling a trend of moderating medical costs in America. Even though more newly-insured people may seek care in 2014, the costs per “unit” (visit, pill, therapy encounter) should stay fairly level – at some of the lowest levels since the U.S. started to gauge national health spending in 1960. That’s due to “the imperative to do more with less has paved the way for a true transformation of the

In the $3 trillion economy that is American health care, the role of information technology is central to transforming this huge piece of U.S. fiscal activity. This week convened the fourth annual Health Datapalooza (HDP) in Washington DC, with the underlying theme, “health engagement is the blockbuster drug of the 21st century” (quoting Leonard Kish). This meeting of over 2,000 registrants – huge growth from the first year’s 400 attendees — is organized by the Health Data Consortium (HDC) , whose CEO Dwayne Spradlin kicked off remarks on Day 2 of HDP4. He described the HDC, a public-private collaboration led

The registered dietitian is an in-demand labor resource for grocery stores around the U.S. Advertising Age covered the phenomenon of the growing clout of dietitians in food chains (April 14, 2013). Let’s dig further into this phenomenon through the Health Populi lens on healthcareDIY and peoples’ ability to bend their personal health care cost curves. Stores such as Giant Eagle, Hy-Vee, Safeway and Wegmans are morphing into wellness destinations, with pharmacies and natural food aisles taking up valuable square footage to meet consumers’ growing demands for healthy choices. Some stores are formalizing their approach to food = health by formulating a

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

Digital health is attracting the likes of Bill Clinton, Lupe Fiasco, Deepak Chopra, Dr. Sanjay Gupta, Arianna Huffington, and numerous famous athletes who rep a growing array of activity trackers, wearable sensors, and mobile health apps. Will this diverse cadre of popular celebs drive consumer adoption of mobile health? Can a “cool factor” motivate people to try out mobile health tools that, over time, help people sustain healthy behaviors? Mobile and digital health is a fast-growing, good-news segment in the U.S. macroeconomy. The industry attracted more venture capital in 2012 than other health sectors, based on Rock Health’s analysis of the year-in-review. Digital health

I endured what very few people could (or would) do in the past ten days: I traveled to New Orleans to the annual conference of HIMSS, the Health Information Management Systems Society, which features hundreds of suppliers to the health care information technology industry. I returned home to kiss my family hello and goodbye, and a day later flew to Austin for the annual South-by-Southwest conference for music, movie and digital folks. The health track at SXSW has grown over the past five years, and provides a start contrast to “health care” as embodied at HIMSS, and “health” translated through

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected. President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star. Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the

Patients are getting comfortable with remote health care – that is, receiving care from a health provider at a distance via, say, telehealth or via a Skype-type of set-up. Furthermore, 70% of people globally saying they would trust an automated device to provide a diagnosis that would help them determine whether or note they needed to see a doctor. Based on the findings from Cisco‘s survey summarized in the Cisco Connected Customer Experience Report – Healthcare, published March 4, 2013, just-in-time for the annual 2013 HIMSS conference, a majority patients the world over are embracing health care delivered via communications

Traditional venture capital in health care is so 2010: welcome to The Greenhouse Effect: How Accelerators Are Seeding Digital Health Innovation, explained in a new report from California HealthCare Foundation written by Aaron Apodaca. Aaron clearly explains the growing interest in and influence of health accelerators, which grew out of the first era of the Internet (read: dot-com bust v 1.0) and the founding of the Y Combinator, an internet incubator that made relatively small investments in exchange for equity positions in start-ups. Health accelerators emerged around 2011, first with Rock Health in San Francisco, which was quickly followed by

A vast majority – 9 in 10 physicians – like mobile health (mHealth) apps, especially when tied to electronic health records (EHRs). eClinicalWorks surveyed physicians in January 2013, and found physicians bullish on mobile health apps for patient benefit – not just for their own office productivity and workflow. Specifically, – 93% of physicians say mobile health apps can improve patients’ health outcomes – 89% of physicians would recommend an mHealth app to a patient – 58% of doctors note a key mHealth benefit is providing patients with appointment alerts and reminders – 2 in 3 physicians say mHealth apps

The proliferation of mobile health (mHealth) apps appears to be an abundant cornucopia of “lite” tools that look simple to access and easy to use. But this growing menu of a la carte choices that promise to keep us healthy, track our numbers, and access useful health information can also, in the words of three Dutch health researchers, “drive us crazy.” Why mobile health app overload drives us crazy, and how to restore the sanity, by Lex van Velsen and colleagues, makes the case that the plethora of mHealth apps available in online app stores is a fragmented, disorganized marketplace

Consumers want multiple functions on single devices, smooth transitions from one screen to another, and value-laden experiences in the post-recession economy. I wrote about this phenomenon during the week of the 2013 Consumer Electronics Show, highlighting Accenture’s survey on consumer attitudes toward technology — the connected home as consumer medical home. In the fast-evolving mobile health (mHealth) era, the consumer-facing suppliers are fast-responding to these customer demands. This is fostering consumer-centered interoperability in mHealth. On the health care system and professional side of health IT, getting to interoperability remains elusive and slow-going, with a customer base (hospitals, physicians) that’s not

PwC has seen the future of health care for the next year, and the crystal ball expects to see the following: Affordable Care Act implementation, with states playing lead roles The role of dual eligibles Employer’s role in health care benefits Consumers’ role in coverage Consumers’ ratings impact on health care Transforming health delivery Population health management Bring your own device Pharma’s changing value proposition The medical device industry & tax impact. In their report, Top health industry issues of 2013: picking up the pace on health reform, PwC summarizes these expectations as a “future [that] includes full implementation of

1 in 3 U.S. adults have enough trust in online health resources that they’ve gone online to diagnose a condition for themselves or a friend. “For one-third of U.S. adults, the Internet is a diagnostic tool,” according to Health Online, the latest survey on online health from the Pew Internet & American Life Project. Nearly one-half of these people eventually sought medical attention. One-third did not. Women are more likely to do online medical diagnoses than men do, as do more affluent, college-educated people. When people perceive they’re ‘really’ sick, 70% get information and care from a health professional and

Reed Tuckson of UnitedHealthGroup was the first panelist to speak at the kickoff of the Digital Health Summit, the fastest-growing aspct of the 2013 Consumer Electronics Show (#2013CES). Tuckson implored the spillover audience to all, “self-deputize as national service agents in health,” recognizing that technology developers in the room at this show that’s focused on developers building Shiny New Digital Things have much to bring to health. As Andrew Thompson of Proteus Medical (the “invisible pill” company) said, “we can’t bend the health care cost curve; we have to break it.” This pioneering panel was all about offering new-new technologies

People enrolled in consumer-directed health plans (CDHPs) and high-deductible health plans (HDHPs) are more cost-conscious than those enrolled in more traditional plans, according to Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey from the Employee Benefit Research Institute (EBRI), published in December 2012. The logic behind CDHPs and HDHPs is that if health plan enrollees have more “skin in the game” — that is, personal financial exposure — they’ll behave more like health “consumers.” By 2012, 36% of employers with over 500 employees offered either HRA- or HSA-eligible plans. About 15% of working age adults are enrolled

“The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more helath information online and will take more responsibility for their care. The doctor/patient relationship will be altered. Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but

This week-after-the-mHealth-Summit gives us the opportunity to synthesize several interesting studies on the state of mobile health in the U.S. with a few days of distance from the excitement of the conference. Deloitte’s report on mHealth in an mWorld asks how mobile technology is transforming health care.  Consumers are driving mHealth growth, Deloitte believes, with mobile apps “enhancing overall consumer engagement” they say. In a future scenario, Deloitte sees health consumers using social health networks for information, motivation and support, self-directing care, and using sensors to monitor and communicate health metrics. Clinicians will have clinical dashboards informed by Big Data

Mobile technology will change the delivery of health care, according to 2 in 3 health IT execs polled in the 2nd Annual HIMSS Mobile Technology Survey, sponsored by Qualcomm Life. Only 2% of health IT management says mobile won’t impact the delivery of health care in the future. This week finds the mHealth Summit convening in Washington, DC, hosting some 3,000 interested stakeholders looking at the intersection of mobile devices and platforms and health and health care. The 2012 theme is Connecting the Mobile Health Ecosystem, and the exhibitor area of the Summit speaks to the broadening of that ecosystem, including

Health care professionals (HCPs) have adopted smartphones and tablets faster than the man-and-woman-on-the-street. As a result, mobile devices have become an all-important channel for communicating information to all clinicians: doctors, nurses and pharmacists. Today, medical practice is “done” via computers: the chart, from MedPage Today’s survey of physicians conducted in July 2012, shows that 100% of doctors get their learning via desktop and laptop computers (THINK: continuing medical education, for example). 88% of doctors go social online, including using point-of-care tools based on MedPage’s definition of “social interactions.” 9 in 10 doctors have increased the use of the internet in

When the phrase “health care innovation” is considered, most people think about technologies like digital imaging, breakthroughs in cancer treatment, and robotic surgery. But before clinicians order or prescribe the use of any of those choices, there’s a cognitive process that gets them to that decision. It’s a cerebral mash-up of information, learned knowledge, and that special art of medicine embodied in the provider’s experience with patients, well-honed over time. How can innovation improve this process? “Healthcare innovation can be defined as the introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention and

Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital

The first day of the Health 2.0 Conference in San Francisco kicked off with a video illustrating the global reach of the Health 2.0 concept, from NY and Boston to Mumbai, Madrid, London, Tokyo and other points abroad. Technology is making the health world flatter and smarter…and sometimes, increasing problematic fragmentation, which is a theme that kept pinching me through the first day’s discussions and demonstrations. Joe Flowers, health futurist, offered a cogent, crisp forecast in the morning, noting that health care is changing, undergoing fundamental economic changes that change everything about it. These are driving us to what may

As the Web Goes Mobile, Healthcare Stands Still, sums up a survey from Makovsky Health and Kelton. Their research finds that, while consumers have beloved relationships with their mobile devices (phones and tablets) and use them regularly for aspects of daily living, healthcare information search is still largely managed via desktop and laptop computers. The infographic organizes some of Makovsky-Kelton’s findings. Of note is that parents are more likely to seek health answers online, Wikipedia has gained in health use since 2011, women are more likely than men to research before filling a prescription, and recommendations from friends and family are

Target, the beloved retail channel for many design-minded value-conscious consumers, has opted in to mobile health through its purchase of SMARTCOACH mobile health coaching devices. SMARTCOACH is part of a growing category of wearable devices that monitor health behaviors like walking and calories consumed. What differentiates SMARTCOACH is the “coach” element, which provides real-time feedback throughout the day. Most other devices in the market simply track and record data. And it’s feedback loops that more experts say are key to sustaining health behavior change. Target will bring the device into stores for purchase in the fall. Like some other wearable

One-half of the members of Kaiser Permanente use the plans’ personal health record system, MyHealthManager. The most-used function of MyHealthManager is accessing lab results, according to KP. Now that Quest, the lab and health information company, has launched the mobile phone app, Gazelle, more health citizens will have access to lab test results. This could be a health-activating opportunity inspiring patient engagement. While Gazelle is a fully functional personal health record (PHR), it’s the connection to lab test results that’s the lightbulb moment. PHRs have been available to health consumers for over a decade. There are millions of users of

Skype and videoconferencing have surpassed the tipping point of consumer adoption. Grandparents Skype with grandchildren living far, far away. Soldiers converse daily with families from Afghanistan and Iraq war theatres. Workers streamline telecommuting by videoconferencing with colleagues in geographically distributed offices. In the era of DIY’ing all aspects of life, more health citizens are taking to DIY’ing health — and, increasingly, looking beyond physical health for convenient access to mental and behavioral health services. The Online Couch: Mental Health Care on the Web is my latest paper for the California HealthCare Foundation. Among a range of emerging tech-enabled mental health

Half of patients globally expect that mobile health will improve health care. These health citizens expect that mobile health will help them manage their overall health, chronic conditions, how they manage their medications and measure and share their vital health information. Welcome to the new mobile health world, a picture captured in PwC’s report, Emerging mHealth: Paths for growth, published in June 2012 and written by the Economist Intelligence Unit. Patients’ views on mHealth are bullish, and while most doctors and payors share that vision, they also expect mHealth to come into focus more slowly, recognizing the institutional, cultural and

  One-third of employers will increase investments in wellness programs in 2013. Employers look to these programs to reduce health care costs, to create a culture of health, to improve workforce productivity, and to enhance employee engagement. Workers say wellness programs are important in their choice of employer. But while employers and employee chasm agree on that point, there’s a gap between how employers see the programs’ benefits, and how aware (or unaware) employees are. Call this a Wellness Literacy Gap, akin to health literacy and health plan literacy. Over one-half of employers believe employees understand the programs they offer,

On May 23, 2012, Pfizer announced its teaming with EatingWell magazine to launch a mobile app for patients on Lipitor. Eight days later, on May 31, 2012, generic versions of Lipitor will hit the market. Lipitor is the best-selling drug in pharmaceutical history, to-date. Sales of the product top $125 billion. While generic atorvastatin has been available in the U.S. since November 2011 from two manufacturers, low prices for the generic will drop to $10 or less for a month’s supply at the end of May. This is Pfizer’s first foray into a prescription drug-affiliated app. The free mHealth app,

Mom is the Chief Health Officer of her family, she’s mobile, and seeking health information and community on-the-go. But underneath the persona of the Mobile Mom, she’s consuming information and sharing perspectives on many other ‘screens,’ too. And that’s the challenge for marketers seeking to grab the attention of this key player in the health ecosystem. There are new survey data from Enspektos‘s report, Digging Beneath the Surface: Understanding the Digital Health Mom, that are must-reading for health industry stakeholders who seek to motivate health behaviors among women, who are at once nurturing wellness, caregiving for sick people, and sharing

Nearly 1 in 2 U.S. adults now uses social media in health, according to Manhattan Research’s latest look into Cybercitizens, fielded in Q311. That 45% of U.S. health consumers use social media in health is a significantly higher percentage than recent studies fielded by PwC and Deloitte, which have found about 1 in 3 consumers using social media for health. Manhattan Research defines social media use in health as having created or consumed health-related user-generated content on blogs, social networks, health ratings websites, online health communities and message boards, or patient testimonials. Key findings are that, 14% of health-social media folks are

There’s a shift in power in health care moving away from providers and suppliers like pharma and medical device companies, toward patients and payers. This is the new health world according to Ernst & Young‘s latest Progressions report called, The third place: health care everywhere. What’s underneath this tectonic shift is the need to bend that stubborn cost curve and address public health outcomes through behavior change. E&Y says look for new entrants, like retailers, IT companies, and telecomms, to be part of the solution beyond traditional health care stakeholders. These participants will be part of both delivery of care